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Laparoscopic double mesh repair of a large Morgagni hernia: a video vignette
Matteo Rivelli,Giulia Turri,Cristian Conti,Alessandro Valdegamberi,Corrado Pedrazzani 대한내시경로봇외과학회 2023 Journal of Minimally Invasive Surgery Vol.26 No.2
Morgagni hernia (MH) is a rare congenital diaphragmatic hernia (CDH) that accounts for less than 2% of surgically repaired CDH in adulthood. Even if this condition is often asymptomatic, surgery is advised due to the risk of life-threatening complications such as volvulus or bowel strangulation. Surgery for MH repair can be performed by transthoracic, transabdominal, laparoscopic, or thoracoscopic approaches. Though laparoscopy has recently improved surgical outcomes, the use of prosthetic meshes and the need for reduction of the hernia sac are still the most debated issues. We present the video of a laparoscopic repair of a large MH with the use of a double mesh technique and no resection of the hernia sac.
Endoscopic Ultrasound Through-the-Needle Biopsy for the Diagnosis of an Abdominal Bronchogenic Cyst
Jessica Cassiani,Stefano Francesco Crinò,Erminia Manfrin,Matteo Rivelli,Armando Gabbrielli,Alfredo Guglielmi,Corrado Pedrazzani 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.5
A 57-year-old woman with epigastric pain was diagnosed with a 6-cm abdominal cystic lesion of unclear origin on cross-sectionalimaging. Endoscopic ultrasound (EUS) demonstrated a unilocular cyst located between the pancreas, gastric wall, and left adrenalgland, with a regular wall filled with dense fluid with multiple hyperechoic floating spots. A 19-G needle was used to puncture thecyst, but no fluid could be aspirated. Therefore, EUS-guided through-the-needle biopsy (EUS-TTNB) was performed. Histologicalanalysis of the retrieved fragments revealed a fibrous wall lined by “respiratory-type” epithelium with ciliated columnar cells,consistent with the diagnosis of a bronchogenic cyst. Laparoscopic excision was performed, and the diagnosis was confirmed basedon the findings of the surgical specimen. Abdominal bronchogenic cysts are extremely uncommon, and a definitive diagnosis iscommonly obtained after the examination of surgical specimens due to the lack of pathognomonic findings on cross-sectionalimaging and poor cellularity on EUS-guided fine-needle aspiration cytology. EUS-TTNB is useful for establishing a preoperativehistological diagnosis, thus supporting the decision-making process.